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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by floatingbridge on October 15, 2010, at 14:44:08
My depression seems to be deepening. So, questions.
1. Can reducing tramadol from 9 37.5 tablets to 5 affect my mood? Then, since I hadn't a pain episode, the last few days I took none. (Could this be a no brainier?)
2. Increasing difficulty getting up and
staying up. Nothing seems to matter. I want to stay fetal. Why is it so difficult to just get up and go through the motions? My default answer is laziness. It becomes more difficult. Is this a symptom of depression? Why is it?3. Concern for my son could always motivate me. That seems to be slipping.
Not enough to motivate me lately. We used to have fun. I enjoyed him. What is happening? I am so flat, so tired, and
scared.I did get out of bed, cook breakfast.
Talked to husband. Decided to take some emergency xanax and half my
allowed tramadol.You'd think after 13 years I'd have a handle on this. So yes, tramadol reduction is having an effect, part of
depression is the desire to go fetal (but
why! Why!). And yes, I have terrible guilt over my decision to be a mother. This will come and go and when the depression affects my son, I will feel horror and despair.
Posted by floatingbridge on October 15, 2010, at 15:06:29
In reply to depression. questions on meds, symptoms, psycholog, posted by floatingbridge on October 15, 2010, at 14:44:08
Two days ago, I finally get in to to rheumy's. Seemed to be a slam dunk dx of depression complicated by whatever. Fibro symptoms, but not really fibro. More chronic fatigue but no sore throat. Not enough sleep disturbance to qualify for chronic pain syndrome. (He ordered a sleep study.) I asked him if he thought I should stop looking, and he said yes.
I still don't understand what depression is. More reading about physiological depression, I suppose. I know I'm neurotic.
Posted by SLS on October 15, 2010, at 15:43:43
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by floatingbridge on October 15, 2010, at 15:06:29
Major Depressive Disorder (MDD) and Bipolar Disorder (BD) can both comprise physical symptoms, including increased pain sensitivity. The brain is the organ that helps direct the activity of the entire rest of the body. Psychosomatics is the study of the physical consequences of having psychological stress. Somatoform illness can present as physical complaints without having a detectable physical illness. The bottom line is that MDD and BD can manifest physical symptoms. After all, it is a physical disease.
http://www.webmd.com/depression/recognizing-depression-symptoms/physical-symptoms
- Scott
Posted by Phillipa on October 15, 2010, at 16:32:33
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by floatingbridge on October 15, 2010, at 15:06:29
FB silly since your docs away but he said stay on same meds right? Sound a bit like withdrawal to me. Depression hurts both mentally and physically. Love Phillipa
Posted by sigismund on October 15, 2010, at 19:08:54
In reply to depression. questions on meds, symptoms, psycholog, posted by floatingbridge on October 15, 2010, at 14:44:08
>1. Can reducing tramadol from 9 37.5 tablets to 5 affect my mood? Then, since I hadn't a pain episode, the last few days I took none. (Could this be a no brainier?)
I didn't need to read past this! Of course it is a no brainer.
I reduced from 2 a day to zero some time back, and I'd only been taking it for 3 weeks. It was reasonably difficult. I wasn't bedridden but I stayed pretty solitary until it passed, which it did in a few days, 5 at the most. And that's only the opiate angle, there's also whatever it does to neurotransmitters.
Posted by sigismund on October 15, 2010, at 19:11:45
In reply to depression. questions on meds, symptoms, psycholog, posted by floatingbridge on October 15, 2010, at 14:44:08
> This will come and go and when the depression affects my son, I will feel horror and despair.
It doesn't have to get inside him.
He could just worry for you and care that you feel bad, rather than become depressed himself.
Posted by morgan miller on October 15, 2010, at 19:20:19
In reply to Re: depression. questions on meds, symptoms, psycholog » floatingbridge, posted by sigismund on October 15, 2010, at 19:11:45
> > This will come and go and when the depression affects my son, I will feel horror and despair.
>
> It doesn't have to get inside him.
>
> He could just worry for you and care that you feel bad, rather than become depressed himself.It can be very detrimental to the development of a child's psyche to take on this kind of worry and care for their parent. It should be avoided if possible.
Posted by floatingbridge on October 15, 2010, at 19:43:40
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by SLS on October 15, 2010, at 15:43:43
The bottom line is that MDD and BD can manifest physical symptoms. After all, it is a physical disease.
>
> http://www.webmd.com/depression/recognizing-depression-symptoms/physical-symptoms
>
>
> - ScottThanks Scott. You know, hearing something that simple helps me come to terms with *this*. Because I don't yet fully accept that it is a physical illness, and that I am to blame causes me (and my family) additional stress and suffering.
So, how best to medicate. I am revisiting last January Stanford consult. Much of what he said, I'm afraid, I wasn't ready to
hear. With another consult, I can compare and perhaps make a more informed decision. Emsam first, if no real response nardil or parnate (nardil
scares me...?), maybe spiked with a bit of dexedrine. Or rTMS which I'll need to
save for.Pieces, of which therapy is a big part. Graded exercise and lifestyle counseling with a chronic fatigue expert--I now have a scrip :)
Thanks for being here. I so appreciate your input.
Posted by sigismund on October 15, 2010, at 19:50:50
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by morgan miller on October 15, 2010, at 19:20:19
>It can be very detrimental to the development of a child's psyche to take on this kind of worry and care for their parent. It should be avoided if possible.
Lots of things should be avoided if possible.
I don't agree. Worry is a part of life. Hardship is a part of life. The important thing is to avoid confusion.
I saw this program about a man. He was a shearer and was to be married at the age of 21 to a nurse. Before the marriage she had a stroke which knocked out her brain stem and she could not move or even speak, though she could breathe unaided. The shearer married her and the whole family cared for her. He even had a further child with her. He would take her out in the car when he mustered the sheep and lift her back to bed when they came back. And of course you ask yourself why he would do this, and the answer has to be that his sense of decency required it. Anyway the guts of the story was that he wanted to earn some damn money by opening a brothel in a country town, which he did.The most moving part of the story was the interview with the 10yo boy who was, of course asked how he felt about his mother's condition, and at this point he dissolved into tears and said 'I just wish she was better' but I have to say he was the very model of sanity, and it is because he understood his situation accurately and he was surrounded by a relentlessly decent environment.
Posted by morgan miller on October 15, 2010, at 21:20:43
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by sigismund on October 15, 2010, at 19:50:50
I think it's dangerous to just accept that life is full of hardship and worry, so a child being exposed to hardship and worry is something they should be able to deal with and overcome.
I was a very "sane", very responsible, very thoughtful, and very solid child at 11 years old. But, in my teens and much of my 20s and thirties I was a mess. In therapy I learned that my mother's struggles after my parents' divorced triggered a part of me that was nurturing, loving, caring, and attentative. I ended up taking care of my mother and she let me(she should NOT have). My being a little adult was very harmful and made it hard for me to truly become an adult in my 20s when I needed to be. Yes, I am just one example, but there are many many people out there that in one way or another were affected by having to take on the role of an adult as a child. Childhood and adolescence are meant to be just that, not "child-adulthood" or "adolescence-adulthood". Children need to be children, this is a fact.
You were fooled in to thinking this child had their sh*t together and was perfectly healthy by the facade of him being forced into taking on this role of a young adult. Of course he seemed perfectly sane to you, he had to be for his mother. I would be curious to see if this child struggles with things because of being burdened at such a young age. I do agree that if he had a very loving and nurturing environment, the chances of taking on this adult-like role and persona damaging him will be much much less.
Personally I'm growing tired of people being a bit too accepting of the hardships in life(no offense). When people take on this belief that children are built to deal with hardships in life, they are less likely to do what they can to try to shield a child in the right ways and give them the right amount of nurturing and love. I am not a fan of overprotecting a child in ways either. I think it is a delicate balance.
Morgan
Posted by floatingbridge on October 16, 2010, at 1:12:43
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by morgan miller on October 15, 2010, at 21:20:43
Hi Morgan, I really appreciate your concern for my son. Thank you. I believe he is being affected somehow. He is, after all, a human being, and that's how we are--affected by others.
You may recall I am a firm supporter of therapy. I'm in therapy. My son will be at least observed/engaged by a child therapist soon. My shrink asked me to
wait a bit. Besides not rushing into things, which I tend to do, he wanted to find a very good, non-invasive therapist.I am the daughter of a depressed
mother. I took care of her. That was the only way I could get her attention. So, I fully know the dangers and what can
happen. However, when I feel horror and despair in the moments when I am disconnected from my son and all of life,
those are clearly my feelings--not his. The more I am aware of my enmeshment issues, I become a better parent.If I remember correctly, you are familiar with attachment disorders. I have done
a reasonable amount of layman's reading, and for quite some time found some of it terribley hopeless. The original insights and observations have often been misinterpreted or applied as boogie bears.Kids needs so much. Kids need connection. When I am unable to connect, on top of depressed, I become
severely triggered. Because I hadn't the resiliency I needed, I fear my son will not. However, he is a separate human being. When my thinking is healthier, I do prefer optimism. Besides connection, a child needs optimism, a good feeling
about himself supported by loved ones. If I look at the statistics predictively, well, many of us are going down. However, if I can manage to find a *balance* (was that you Morgan or Sigi?), the statistics give me information. The more
accepting I am of illness, the more I can see my son, discover and dismantle family/generational patterns, make better compensations for my weakness, etc.When Sigi shared his two stories, I didn't
feel he was trivializing mine or anyone's situation. These resiliencies happen despite the odds we know too well. I feel he was offering hope based, in part, on his own experience. No human being alive, (o.k., that is a totalizing and insupportable statement), is neurosis
free. Sometimes the very easiest answer used to be to blame the parents (usually mum) for autism, schizophrenia, personality *disorders*....Maybe that is the way your views lean; I
don't know. I have a great gift in a friend, older than me, from war and postwar Europe. She was raised by a
depressed, single mother. She told me
this one day when I confided my parenting fears. I was really stunned. I consider her one of the strongest, self-actualized people I have ever met. If I had read her story in a book, I could
dismiss it. Not sitting there, knowing her.She's not perfect. Now, if I could disentangle myself from perfection, I'd
suffer much less. (And be a better parent.)
Posted by floatingbridge on October 16, 2010, at 1:26:54
In reply to Re: depression. questions on meds, symptoms, psycholog » floatingbridge, posted by sigismund on October 15, 2010, at 19:11:45
> > This will come and go and when the depression affects my son, I will feel horror and despair.
>
> It doesn't have to get inside him.
>
> He could just worry for you and care that you feel bad, rather than become depressed himself.Thanks Sigi. I'd love to spare him the worry, but shortly after his birth, I did,
sadly may I add, realize that raising
another Siddhartha was beyond my abilities.Today was not a total wash, I'm happy to say. I managed to play and engage. What really frightened me was waking up feeling so dead inside that I couldn't even fake smile. Thank God that passed.
But I am worried. Being that close to the edge is scary. I've got some decisions to make, because that is one of the indicators of a big slide :(
Then, of course, there is stupidity. Why I still am so delayed in recognizing discontinuation effects, I don't know. So double thanks.
Posted by floatingbridge on October 16, 2010, at 1:43:52
In reply to Re: depression. questions on meds, symptoms, psycholog » floatingbridge, posted by Phillipa on October 15, 2010, at 16:32:33
Hi Phillipa, well my pdoc said stay on same drugs, up xanax if needed, (and I had it so low for so long-- but he reminds me there's no hero points given for not taking meds when necessary), email him. He, my pdoc is not convinced about stopping tramadol. I suspect he may note mood improvement. He was against it at first (worried about seizures).
It's my back doctor that prescribes the tramadol. I think he thinks since it isn't controlling pain, I need to switch to cymbalta or savella. But he is diligent about tapers. Yeah, I think my difficulties were sped along by not taking tramadol for two days. I can only say duh. If I don't hurt, I guess I forget. The complete lapse wasn't intentional.
Pdoc is definitely not keen on the above. And since he's worked so hard to stabilize me, he doesn't take any change lightly.
I can hang in there, right?
Thanks Phillipa
Posted by floatingbridge on October 16, 2010, at 2:05:51
In reply to Re: depression. questions on meds, symptoms, psycholog » floatingbridge, posted by Phillipa on October 15, 2010, at 16:32:33
Hi Phillipa, well my pdoc said stay on same drugs, up xanax if needed, (and I had it so low for so long-- but he reminds me there's no hero points given for not taking meds when necessary), email him. He, my pdoc is not convinced about stopping tramadol. I suspect he may note mood improvement. He was against it at first (worried about seizures).
It's my back doctor that prescribes the tramadol. I think he thinks since it isn't controlling pain, I need to switch to cymbalta or savella. But he is diligent about tapers. Yeah, I think my difficulties were sped along by not taking tramadol for two days. I can only say duh. If I don't hurt, I guess I forget. The complete lapse wasn't intentional.
Pdoc is definitely not keen on the above. And since he's worked so hard to stabilize me, he doesn't take any change lightly.
I can hang in there, right?
Thanks Phillipa
Posted by SLS on October 16, 2010, at 6:53:26
In reply to Re: depression. questions on meds, symptoms, psycholog » morgan miller, posted by floatingbridge on October 16, 2010, at 1:12:43
> She's not perfect. Now, if I could disentangle myself from perfection, I'd
> suffer much less. (And be a better parent.)Are you generally rigid or a perfectionist?
It took awhile for me to forgive my parents for their imperfections and the extent to which their parenting contributed to my mental illness. Of course, I never told them that. It is often easier to afix blame to parents than it is to accept them as being human. Some can leave a hell of a lot of scars. It can take awhile to accept the scars without blaming, understanding that there is cause-and-effect that cannot be overlooked unless one wishes to remain in denial.
I don't know. Just some psychobabble.
- Scott
Posted by morgan miller on October 16, 2010, at 11:11:35
In reply to Re: depression. questions on meds, symptoms, psycholog » morgan miller, posted by floatingbridge on October 16, 2010, at 1:12:43
I'm really sorry you are struggling and not feeling like you can always give your child what they need. It must be awful. The good thing is that you seem to be a very caring passionate individual that is more aware of what you need to be for your child than many other parents. This awareness and knowledge unfortunately can make things more difficult for you. Please try not to stress too much over how your condition may affect your child. Stressing in this way may only make things worse. Try to take it easy on yourself a little and balance your illness with your awareness. I understand this can be very difficult. Hope you feel better soon and find a more permanent solution!
Morgan
Posted by floatingbridge on October 16, 2010, at 13:16:53
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by morgan miller on October 16, 2010, at 11:11:35
Morgan, that was a very sweet note. Thank you, too, for wishing me luck. I need it :)
It helps me, sometimes to talk. After a life of holding things in. Thanks for listening.
Posted by floatingbridge on October 16, 2010, at 13:38:16
In reply to Re: depression. questions on meds, symptoms, psycholog » floatingbridge, posted by SLS on October 16, 2010, at 6:53:26
>Are you generally rigid or a perfectionist?
Yes, both, though many people are surprised to find out. I know I was. It's the school of 'If you can't do it perfectly, why try?'
>
> It took awhile for me to forgive my parents for their imperfections and the
extent to which their parenting contributed to my mental illness. Of course, I never told them that. It is often easier to afix blame to parents than it is to accept them as being human. Some
can leave a hell of a lot of scars. It can take awhile to accept the scars without blaming, understanding that there is cause-and-effect that cannot be overlooked unless one wishes to remain in denial.
>
Scott, how did you ever do it? I sometimes ask my pdoc about balancing forgiveness, blame, anger, grief. Blame is an interesting phenomena. Actually, I've not looked up it's etymology. Lately, I'm
examining my need, impulse, tendency, ? to blame. Some therapist's encourage blame, and that maybe quite appropriate
and necessary case by case. I know I stumble on it. Yes, cause and effect. Of
course forgiving them (and God and the world) would include forgiving myself. Ah, perfectionism.> I don't know. Just some psychobabble.
>
Me neither. Gave me something to think about, though. Then sent along some of my own :)> - Scott
Posted by Phillipa on October 16, 2010, at 21:49:39
In reply to Re: depression. questions on meds, symptoms, psycholog » Phillipa, posted by floatingbridge on October 16, 2010, at 2:05:51
Sorry gone all day just getting around to babble. See to me if the pain wasn't noticed by you then the tramadol was working hence no pain. Seems that pain management today is very against any meds for pain. Now it's lidocaine patches and the NSAID"s patches you mentioned. From the computer fingers to you from me my Mother was sick from the day I was two blamed me, I had to take care of her, Father was working, drinking beer, who knows, said the carrying me up two flights of stairs startted her illness and I believed it til had my own first child and Bingo moment when carrying her up stairs a light turned on in my brain and I thought " It wasn't me no way carrying my Daughter up stairs can make me sick". I thought back to the tantrums she threw, the foaming at mouth if I did something to upset her and realized it was the new realease of cortisone and all the injections she was getting causing the outbusts. No one knew then how strong and dangerous it can be if not used properly so I forgave her as psychosis can be a too high dose of cortisone. Also she'd get migraines be in bed for three days I'd have to hold her head over a toilet as she vomited and said she would die as she knew she'd bust a vessel in her brain with the vomiting. Sheer nonsense. I raised my kids with nothing but stressing the positive things they did to build good self esteem. Didn't dwell on negatives. So today they are all so independant never hear from them or rarely but all three are very successful in life. So I know I gave them the freedom to spread their wings and fly. So kids do realize like I did at some special moment that they didn't cause they parents problems. Yes emotionally was some would say abused. But I forgive and that is the healing to me. Just my own story and take on kids. I'd see if your pdoc will prescribe the tramadol if he thinks it's helping. Why take a med for depression if it's really pain causing depression. Viscious cycle and take the xanax for now. No heros weren't meant to suffer in pain. Love Phillipa
Posted by floatingbridge on October 17, 2010, at 2:13:43
In reply to Re: depression. questions on meds, symptoms, psycholog » floatingbridge, posted by Phillipa on October 16, 2010, at 21:49:39
Phillipa, that's really pretty amazing, really. The *bingo* moments you talk about. They really are quite, well, miraculous, don't you think? My pdoc is very interested in those moments, too. Thank you for sharing those details of your life. Cortisone shots--yes, now we know. How frightened I imagine you were. Interesting, too, you found your way to nursing--I mean that you found
something worthwhile to do with your experiences. Someone might say to conquer the demons, but I think to myself more like taming them. Maybe?Your story brings to mind something about my dad. You know about my mother's lifelong illnesses and self-
absorption, but I don't think/ remember her ever telling me I was the cause. (I just tried to fix her.) That seems so awful, Phillipa. I'm sorry that happened
to you.My dad would say terrifying things to me--kinda like your mom, but he wasn't physically ill. He was a rage-aholic, given to unpredictable
outbursts--raving, literally, sometimes spittle flying. I just remember when he told me he had just drunk from a Pepsi bottle before he realized it was chipped, and now all we could do was wait and
see if he died. I don't know if he would say things like that to my mother. God
only knows. Funny. When you tell me about your mom, I can feel myself getting p*ssed. Then a few minutes later,
I remember my father. I just feel sort of ill. Not your fault Phillipa, just, I don't know, something to look at in a different light, something to watch.Take care and (((Hugs)))
Oh. I don't think the pain causes the depression--it makes it worse. Then, there is the depression that makes the pain worse. I'm rethinking things.
Posted by morgan miller on October 17, 2010, at 11:49:32
In reply to Re: depression. questions on meds, symptoms, psycholog » SLS, posted by floatingbridge on October 16, 2010, at 13:38:16
>Scott, how did you ever do it? I sometimes ask my pdoc about balancing forgiveness, blame, anger, grief. Blame is an interesting phenomena. Actually, I've not looked up it's etymology. Lately, I'm
examining my need, impulse, tendency, ? to blame. Some therapist's encourage blame, and that maybe quite appropriate
and necessary case by case. I know I stumble on it. Yes, cause and effect. Of
course forgiving them (and God and the world) would include forgiving myself. Ah, perfectionism.A good therapist will help you understand the role your parents played in your development. They will show empathy and compassion. They do not want you to hold on to anger and continue to blame your parents. Instead, they want you to be able to heal through learning to have compassion for yourself, understanding that you were not just born this way and it is not your fault you have struggled with some things. Gaining understanding of how you were affected in your childhood will both give you the power to do something about it and let yourself off the hook for not being able to be better in some ways. A good therapist will also try to guide you in a way that helps you process and channel your anger properly so that it is not turned against yourself and affecting the way you feel and behave. The point of therapy is not to play the blame game, but to use the knowledge you gain to help you nurture yourself back to better health.
It's so true that in order to forgive others we have to also be able to forgive ourselves. Without forgiveness, we are just stuck in a state that will not allow us to move forward and heal.
Posted by floatingbridge on October 17, 2010, at 17:21:04
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by morgan miller on October 17, 2010, at 11:49:32
Posted by Phillipa on October 17, 2010, at 19:25:12
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by morgan miller on October 17, 2010, at 11:49:32
Yes Morgan in that moment I definitely did. Good summation.Phillipa
Posted by creepy on October 20, 2010, at 12:10:11
In reply to depression. questions on meds, symptoms, psycholog, posted by floatingbridge on October 15, 2010, at 14:44:08
I would never have believed it before, but now Im convinced that depression can be very much a physical illness with physical consequences.
Fatigue and pain can certainly come from depression, with no other biological causes.
Ive been feeling like total crap for months and good results in one particular therapy session made me feel great.. It was pretty amazing. Im assuming that if/when I go back on an AD Id feel even better.
Tramadol has SNRI effects.. its very likely youre getting some rebound depression.
If your primary symptoms are pain, fatigue and depression, Id see if you can manage on just an NRI.
SSRIs and SNRIs are all pretty big weight gainers for most folks, but if your depression only responds to serotonin youre stuck there.
Posted by floatingbridge on October 21, 2010, at 1:04:56
In reply to Re: depression. questions on meds, symptoms, psycholog, posted by creepy on October 20, 2010, at 12:10:11
Thanks Creepy. Now one nri is strattera? I did so poorly. So the nri classification confuses me. However, since starting this thread, I am again disinclined to try neurontin at this point. (A very successful thread--helped me make up my mind :)
Yes, a real personal duh! regarding the unintentional discontinuation of tramadol.
We're writing to each other on a few threads. Did you happen to get a babblemail from me maybe a month ago? I don't remember even what I sent.... Maybe just inquiring about your current treatment. This is what I understand:
Therapy
About to start emrd (sp)
Reducing or off of all meds?Yes, I'm really getting the physical thing--like a paradigm shift. Still feel scr*wed. But hey.... I'm still here.
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